On March 29, 1965, Richard J. O'Brien, Esq., age 44, committed suicide. Like his daughter Christine, O’Brien lived with a debilitating mental illness. The justice and health care systems had failed him. On this past Friday, June 24, 2011, O’Brien would have been 90. He gifted his daughter with a rich legacy- a passion for justice. This win is for him.

Tuesday, March 17, 2009

"Injustice anywhere is a threat to justice everywhere." ~Martin Luther King Jr.

It is estimated that mental illness affects 1 in 5 families in America. Shocking statistics considering the suffering of the mentally ill, their family, friends, and business associates. While the best treatments for serious mental illnesses today are highly effective, it is unconscionable that many mentally ill are denied the necessary health care by their for profit health plans.

It was in July 2005 when I first learned of a secret agenda of my HMO, Carelink Health Plans Inc, to deny me my rights under my contract. It was in May 2005 that Carelink, an affiliate of Coventry Health Care, Inc of Bethesda, MD, denied my specialist’s request for medically necessary surgery. Since then my single goal has been to expose their despicable, abusive activities.

Today I advocate for quality health benefits for the mentally ill, the most vulnerable in our society. I have investigated Coventry Health Care, Inc of Bethesda MD for over three years and have discovered shocking, bizarre behavior described in this blog.

“Return on equity is an eye-popping 33%.” Courtney Smith and Company, September 4, 2004

“…(Coventry reported “it made $147.5 million, or 92 cents a share, compared $133.1, or 81 cents a share, in the third quarter of 2005. Revenue jumped 14% to $1.91 billion.”MarketWatch, Oct 27, 2006

Coventry Health Plan’s “ Medical Loss Ratio (MLR)((1)). Health plan commercial group MLR was 78.4% in the first quarter, a 50 basis point improvement over the prior year quarter.”…” * Medical Loss Ratio (MLR). Medicare Advantage MLR of 82.3% increased 40 basis points over the prior year quarter driven by the new Private-Fee-For-Service business. Medicare Part D MLR of 94.7% improved 330 basis points over the prior year quarter and Medicaid risk MLR of 86.5% increased 260 basis points over the prior year quarter.” BNET April 2007

Greed likely fueled one of the highest salary packages for a CEO of a US corporation in 2004. As is widely reported, former Coventry CEO Dale Wolf earned an obscene salary package of $32,000,000.00.

As a scholar of biblical history would note, anger is a positive emotion when it spotlights serious issues such as that noted in the following New York Times News Analysis by Adam Nagourney:

Obama Braces for a Backlash Over Wall Street Bailouts

WASHINGTON — The Obama administration is increasingly concerned about a populist backlash against banks and Wall Street, worried that anger at financial institutions could also end up being directed at Congress and the White House and could complicate President Obama’s agenda.

…“We’ve got enormous problems that need to be addressed,” David Axelrod, Mr. Obama’s senior adviser, said in an interview. “And it’s hard to address because there’s a lot of anger about the irresponsibility that led us to this point.”“This has been welling up for a long time,” he said.

What has been the response of the public to this NY Times news analysis?“…I wouldn't call this a populist revolt. I'd call it a revolt of common sense.” ~Rowerin V, Washington, DC

“…Please, Mr. President! I implore you. Arrest these criminals! Prosecute them! replace all the execs at these banks, insurance companies, stock brokerages! Break them up and re-open them as honest businesses, with all the proper regulations and safeguards in place. Please, Mr. Obama.” ~ davekliman, Glen Cove, NY

“…They're right to worry about a backlash. Warmer weather is coming, and with it will come hoards of angry and disgusted taxpayers carrying signs. We've had enough! What's that address for AIG again? Anybody have a list of their affiliates? ~ BG in NC, North Carolina”

Many Americans are seeing a very dark cloud looming in their future. Daily, Americans awaken to more frightening news about an unprecedented economic crisis and about the intense suffering of innocent Americans. It’s a time of turbulence, apprehension, and alarm.

Many also believe that there is a dark cloud hanging over the health care industry, too. Politicians and health care advocates say that the under regulated system is broken. As we begin to ponder the cost to the consumer, we, too, grow angry. We demand answers.

Health care does matter. It’s our right. Never forget this.

Tuesday’s TaleDon’t Let the Bastards Wear You Down

There's an old story about union boss Jimmy Hoffa who was frequently indicted by the government for alleged illegal activities. To keep himself balanced, Jimmy had a plaque placed on his desk. It read: "Illegitimi Non Carborundum (Don't let the bastards wear you down").

Carelink Health Plans, Inc. of West Virginia and its affiliate Coventry Health Care, Inc. of Bethesda MD have created a trail of lies. Their nearly impenetrable system of deceit was not fully protected from my lengthy investigation as published in my blog.

It was May 2005. Dr. Bernard Costello, my surgeon, requested Carelink’s authorization for medically necessary surgery. On July 29, 2005, Carelink denied my appeal for this benefit citing the requirement that our company purchase a rider as stated in our policy.

My husband Tom contacted his Carelink Sales Representative Michelle Gill to discuss this exclusion. Gill innocently told Tom that there never was such a rider, that this nonexistent rider could be part of a future appeal.

Just words in a policy. More of the same. Tactics to deny. Deceitful abuses. It took Carelink twenty-two months to authorize my surgery. One legal maneuver after another. From May 2005 until April 12, 2007.

There is something very wrong with this system. Time equals $ to Coventry. Time equals life to me.

On March 27, 2009, I will experience being deposed by Carelink’s legal team in preparation for my civil lawsuit Christine Stenger v. Carelink Health Plans, Inc and Patrick Dowd (former CEO). My conscience is clear. There's a smile followed by a sensation of peace, as I begin to experience a small taste of victory, for I am winning.